32A-153 30 Strong St ZPA 2015-09-02------
File # MP-2016-0012
APPLICANT/CONTACT PERSON Mohamed Nasodradumal
ADDRESSIPHONE 42 Valley Village Place
PROPERTY LOCATION 30 STRONG AVE
MAP 32A PARCEL 153 030 ZONE CB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: Convenience Store BuildQut
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner! Statement or License
3 sets ofPlans I Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO.J(MA TION PRESENTED:
_V_AAnpmproved __Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER: § ________
Intermediate Project :,___Site Plan AND/OR'---...__,Special Permit with Site Plan
Major Project: Site Plan ANDIOR Special Permit with Site Plan
ZONING BOARD PERMIT REQUIRED UNDER:
Finding~____ Special Permit _____ Variance* ______
___Received & Recorded at Registry ofDeeds ProofEnc1osed:...-____
___Other Permits Required:
~__Curb Cut from DPW ___Water Availability ___Sewer Availability
___,Septic Approval Board ofHealth ____Well Water Potability Board ofHealth
----
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission ____Permit DPW Storm Water Management
Signature ofBuilding Official
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health, Conservation Commission, Department
of public works and other applicable permit granting authorities.
* Variances are granted only to those applicants who meet the strict standards ofMGL 40A. Contact the Office of
Planning & Development for more information.
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Please type or print all information and return this form to the Building
Inspector's Office with the $tdJ5filingfee (check or money order) pa.yable to the . If 54 City ofNorthampton . -
1. . Name of Applicant: II/)OltfJ ~'!7]J AI1J5oro/fI)J)U tYJl91 CW3) 3"r-!2-if7 •
Address: Y-2. I'IT1-L 1:-1 J/ILt.ttp~. PLI1f!.ea-TelePhone(¥!3) 3b2-t!)'fbj
( _ 7JY'?fiE:I1f7 /1'7/7 O{C!102. • I ' ' .
,2. OWner of Property: c;,Il~0 /erYn':LY) I;'::' 64~~ KOJ' klRJfkC-WI.70 0 ~
Address' 3 {) Sfr£wJ..1 /Jv4?htJ..R... Nrfh~~'-J Telephone( 'fj3) S3~-y-s.fli c,,~: . V "i'\~\I,~~
3. Status of Applicant: Owner Contract Purchaser Lessee' V'" Other (explain) _______
4. Job Location:...3 0 -~'}'~t!JVG~ Nfbrfk~JV(-ftayt,
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5. Existing Use of Structurel Property:_ ..__'J"_e:~UJ_c._(;:_R._~=---,_s"_T_cH,--t~____________
6. Description of Proposed UselWork/Project/Qccupation: (Use additional sreets if-necessary):
7. Attached Plans: Sketch PLan Site Plan Engineered/Surveyed PLans ___v--: '
8. Has a SpeciaL Permit/Variance/Finding ever been issued for/on the site?
NO ____ DON'T KNOW ____ YES ____ IF YES, date issu~d:_______
IF YES: Was the permit recorded at the Registry of Deeds?
NO ____ DON'T KNOW ____ YES, ____
IF YES: enter Book ____ Page ____-and/or Document # ______
9.Does the site contain a brook} body of water or wetLands? NO __ DON'T KNOW ___ YES __
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained ____ Obtained ----;r--, date issued: _______
(Form Continues On Other Side)
W:lJ)ocllments\FORMS\original\Building.Inspector\Zoning-Permit-Application-passiye.doc 8/412004
12
. 1D. Do any signs exist on the property? YES ____ NO X
IF YES, describe size, type and location:_________________--'_____
YES ~. NO___Are there any proposed changes to or additions of signs intended for the property?
IF YES, ~SCribe size, type and location: AI ~ f'C4.1"U{?£ ~ ~ !j rJ
. 11. Will the c~truction activity disturb (clearing, grading, excavation, or'filling) .over 1 acre or is it part of a common
plan of de ~fbpment that will disturb over 1 acre? YES NO·
IF YES, the~orthampton Storm Water Management Perm it from the ;PW Is required.
ALL )NFORMATION~)~BE~OMPLETEDJ or PERMIT CAN BE DENIED DUE TO LACK O. F INFORMATION
. . This colWTf11res81'1Jed
. 'foruse by theBuilding
. Depa:rtInent .
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!LotSize
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. Frontage
Setbacks
iBuilding Height
i
Front
Side
Rear
i Building Square Footage I
%Open Space: (lot area
minus buHding a: paved
parking
# of Parking Spaces
# of Loading Docks
'\. EXISTING I PROPOSED I REQUIRED BY
'\. ZONI:NG
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13. Certificati~n: I her:by.fe~ifY that the information contained herein is true and accurate tothe best o~
my knowledge. I .~
Date: :5 j-2-S/:lOlr Applicant's Signature....:~.......:;.;A:..:.....~:...·_~~.__________
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NOTE: Issuance of a zoning permit does notrelieve an applicant's bur"den to comply -with an zoning
requirements and obtain an required permits from the Board ofHealth, Conservation Commis'sion,
Historic andArchitectural Boards, Department ofPublic Works and other applicable permit granting
authorities.
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